Evidence map›Paper›PMID 37468932›Full record

Trial reportBMC medicine2023

Early non-response as a predictor of later non-response to antipsychotics in schizophrenia: a randomized trial.

Yujun Long, Qiongqiong Wu, Ye Yang, Jingda Cai, Jingmei Xiao, Zhaoqian Liu, Yifeng Xu, Ying Chen, Manli Huang, Ruiguo Zhang and 17 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03451734. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03451734 completed

Optimizing and Individualizing the Pharmacological Treatment of First-episode Schizophrenic Patients

Ran2018Enrolled2,000Registered outcomes4Posted comparisons0ConditionsMetabolic Syndrome, SchizophreniaArmsadjunctive group, antipsychotic medications, metformin and lifestyle intervention
Open the trial in the graph
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 19 institutions in 1 country.

Yujun Long *Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
Qiongqiong Wu *Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
Ye YangDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
Jingda CaiDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
Jingmei XiaoDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
Zhaoqian LiuDepartment of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Yifeng XuDepartment of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ying ChenHuaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Manli HuangDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Ruiguo ZhangDepartment of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi, China.
Xijia XuDepartment of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, Jiangsu, China.
Jian HuDepartment of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Zhifen LiuDepartment of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Fang LiuDepartment of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Yingjun ZhengDepartment of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Huaqing MengDepartment of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Zhimin WangThe National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Yanqing TangDepartment of Psychiatry, the First Hospital of China Medical University, Shenyang, Liaoning, China.
Xueqin SongDepartment of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Yunchun ChenDepartment of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Xueyi WangDepartment of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Tiebang LiuDepartment of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
Xiaoli WuDepartment of Psychiatry, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Maosheng FangWuhan Mental Health Center, Wuhan, Hubei, China.
Chunling WanBio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China.
Jingping ZhaoDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
Renrong WuDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China. wurenrong@csu.edu.cn.
Second Xiangya Hospital of Central South University · CNCentral South University · CNShanghai Jiao Tong University · CNWest China Hospital of Sichuan University · CNBeijing Anding Hospital · CNChongqing Medical University · CNFirst Affiliated Hospital of Zhengzhou University · CNFirst Affiliated Hospital Zhejiang University · CNFirst Hospital of China Medical University · CNFirst Hospital of Shanxi Medical University · CNGuangzhou Medical University · CNHarbin Medical University · CNHebei Medical University · CNJinzhou Kangning Hospital · CNKunming Medical University · CNNanjing Brain Hospital · CNShanxi Medical University · CNSun Yat-sen University · CNXijing Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt remains a challenge to predict the long-term response to antipsychotics in patients with schizophrenia who do not respond at an early stage. This study aimed to investigate the optimal predictive cut-off value for early non-response that would better predict later non-response to antipsychotics in patients with schizophrenia.

methodsThis multicenter, 8-week, open-label, randomized trial was conducted at 19 psychiatric centers throughout China. All enrolled participants were assigned to olanzapine, risperidone, amisulpride, or aripiprazole monotherapy for 8 weeks. The positive and negative syndrome scale (PANSS) was evaluated at baseline, week 2, week 4, and week 8. The main outcome was the prediction of nonresponse. Nonresponse is defined as a < 20% reduction in the total scores of PANSS from baseline to endpoint. Severity ratings of mild, moderate, and severe illness corresponded to baseline PANSS total scores of 58, 75, and 95, respectively.

resultsAt week 2, a reduction of < 5% in the PANSS total score showed the highest total accuracy in the severe and mild schizophrenia patients (total accuracy, 75.0% and 80.8%, respectively), and patients who were treated with the risperidone and amisulpride groups (total accuracy, 82.4%, and 78.2%, respectively). A 10% decrease exhibited the best overall accuracy in the moderate schizophrenia patients (total accuracy, 84.0%), olanzapine (total accuracy, 79.2%), and aripiprazole group (total accuracy, 77.4%). At week 4, the best predictive cut-off value was < 20%, regardless of the antipsychotic or severity of illness (total accuracy ranging from 89.8 to 92.1%).

conclusionsSymptom reduction at week 2 has acceptable discrimination in predicting later non-response to antipsychotics in schizophrenia, and a more accurate predictive cut-off value should be determined according to the medication regimen and baseline illness severity. The response to treatment during the next 2 weeks after week 2 could be further assessed to determine whether there is a need to change antipsychotic medication during the first four weeks.

trial registrationThis study was registered on Clinicaltrials.gov (NCT03451734).

Indexed as

Antipsychotic AgentsSchizophreniaAmisulprideAripiprazoleHumansOlanzapineRisperidoneTreatment OutcomeAmisulprideAntipsychotic AgentsAripiprazoleOlanzapineRisperidoneAtypical antipsychoticEarly responsePredictionSchizophrenia

Identifiers

PMID37468932
PMCPMC10354903
OpenAlexW4384819558

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.